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Airborne diseases; Waterborne diseases; Disease surveillance; Public health response; Emerging infections; Environmental health; Re-emerging diseases; One Health; Climate change; Early warning systems

Introduction

The burden of infectious diseases transmitted through air and water remains a significant concern in public health, particularly in low- and middle-income countries where environmental health infrastructure is often inadequate [1]. In recent decades, both emerging and re-emerging diseases have posed repeated threats, driven by factors such as rapid urbanization, global travel, ecological disruption, and climate variability [2]. Diseases such as COVID-19, H1N1 influenza, Legionnaires’ disease, cholera, and leptospirosis illustrate the evolving nature of pathogen transmission in relation to environmental and human factors [3]. Airborne diseases, including influenza, measles, tuberculosis, and coronaviruses, are primarily spread via respiratory droplets and aerosols. The increasing urban population density and inadequate ventilation in many areas contribute to the efficient spread of these pathogens [4]. In contrast, waterborne diseases such as cholera, hepatitis A, dysentery, and various protozoal infections result from contaminated water sources, often due to poor sanitation, infrastructure decay, and flooding [5]. Airborne diseases such as influenza, tuberculosis, COVID-19, and measles spread primarily via respiratory droplets or aerosols. Their transmission is often amplified in crowded environments with poor ventilation and inadequate healthcare access. Meanwhile, waterborne diseases such as cholera, typhoid, hepatitis A, and giardiasis result from ingestion of water contaminated with human or animal waste [6]. The risk of outbreaks is particularly high in communities lacking proper sanitation, safe drinking water, and hygiene education. Emerging diseases are those newly appearing in a population or rapidly increasing in incidence or geographic range. In contrast, re-emerging diseases are those that had previously declined but are resurging due to changes in host, environment, or pathogen dynamics [7]. The ongoing evolution of pathogens, combined with lapses in vaccination coverage and environmental degradation, facilitates their reappearance in previously controlled or unaffected regions.

Public health surveillance systems serve as the backbone of disease prevention and control. However, current systems in many parts of the world are fragmented, reactive rather than proactive, and under-resourced. This undermines the timely detection of outbreaks and the implementation of effective response strategies. The COVID-19 pandemic exposed glaring gaps in global preparedness and surveillance, prompting a renewed focus on strengthening health infrastructure, data sharing, early warning systems, and intersectoral collaboration [8].

Furthermore, the One Health approach recognizing the interconnectedness of human, animal, and environmental health has gained prominence in the discourse on infectious disease surveillance. Integrating environmental monitoring with traditional epidemiological methods can help anticipate outbreaks linked to water pollution, air quality degradation, and zoonotic spillovers. The deployment of advanced tools such as biosensors, metagenomics, environmental DNA (eDNA) monitoring, and artificial intelligence-based modeling is revolutionizing disease tracking and prediction.

Emerging diseases refer to those appearing in a population for the first time or rapidly increasing in incidence or geographic range, while re-emerging diseases are those that were once controlled but are now showing resurgence. Understanding the dynamics behind these patterns is critical to developing surveillance tools that can detect outbreaks early and implement rapid response strategies to mitigate the health and socioeconomic impacts.

Rise in disease incidence

Epidemiological data from 2010 to 2024 reveal a steady rise in outbreaks of air and waterborne diseases, particularly in low- and middle-income countries (LMICs). For example, cholera outbreaks increased by 35% globally between 2018 and 2023, according to WHO data.

Re-emergence of controlled diseases

Diseases previously under control, such as diphtheria, typhoid fever, and cholera, are resurging due to antibiotic resistance, climate change, urban overcrowding, and water supply disruptions.

In India, there has been a 12% increase in typhoid cases over the last five years, coinciding with urban water contamination crises.

There is a strong correlation between climate-related events (floods, droughts) and increased outbreaks of diarrheal diseases and Legionnaires’ disease.

A case study in Bangladesh after the 2022 floods showed an 80% spike in waterborne illnesses in affected districts.

A survey of 15 countries showed that only 40% have fully operational disease surveillance systems that integrate environmental data with real-time outbreak alerts. Many rural regions still rely on manual reporting, causing significant delays in outbreak response. Pilot programs using integrated digital surveillance tools (e.g., mobile health reporting, GIS mapping) in Kenya and the Philippines demonstrated a 60% faster detection and containment rate during cholera and leptospirosis outbreaks.

Community-led water sanitation and hygiene (WASH) interventions reduced diarrheal disease incidence by 30% in urban slums within one year.

Genetic sequencing has identified new waterborne pathogens in flood-hit regions of Southeast Asia and Africa, some of which show multi-drug resistance, highlighting a need for advanced molecular diagnostics in routine surveillance.

Conclusion

The rising incidence of emerging and re-emerging air and waterborne diseases demands a multidimensional and coordinated response. Surveillance systems must be modernized to allow real-time data sharing and analysis, while public health infrastructures require enhancement to respond swiftly and efficiently. Integration of One Health principles, which recognize the interconnection between human, animal, and environmental health, is crucial for preventing outbreaks at their source. Moreover, investment in research, laboratory diagnostics, clean water supply, sanitation services, and air quality monitoring will fortify defenses against these persistent public health threats. As the world continues to grapple with both old and new pathogens, proactive strategies in surveillance and response will be key to safeguarding global health security.

References

1. Ji LC, Chen S, Piao W, Hong CY, Li J L, et al. (2022)  Biomed Environ Sci 35: 146-150.

, , Crossref

1. Blomgran R, Desvignes L, Briken V (2021)  Cell Host Microbe 11: 81-90

, , Crossref

1. Cohen NB, Gern MN, Delahaye JN (2018)  Cell Host Microbe 24: 439-446.

, , Crossref

1. Corleis B, Dorhoi A (2019)  Immunol Lett 221: 56-60.

, , Crossref

1. Conradie F, Diacon AF, Ngubane H, Howell L (2020) . N Engl J Med 382: 893-902.

, , Crossref

1. Dorman VB, Nahid B, Kurbatova MK (2012) Four-month rifapentine regimens with or without moxifloxacin for tuberculosis . N Engl J Med 384: 1705-1718.

, , Crossref

1. Gannon AD, Darch SE (2021)  mBio 12: 01217-01220.

, , Crossref

1. Pavlik I, Ulmann V, Falkinham JO (2022)  Microorganisms 10: 1516.

, , Crossref